Looks like no restriction so not cancer. T1 and STIR below. Do you agree?
One of my compadres also thought it looked chondroid like an enchondroma
(like I initially did).
I showed to Avneesh and his response is benign, leave it alone, behaves
like fluid.
Great news for the patient!
[image: DWI 3.jpg]
[image: T1.jpg]
[image: STIR.jpg]
On Wed, Jan 19, 2022 at 4:31 PM Phillip Tirman <ptirmanmd@gmail.com> wrote:
> 29 y/o presents with severe knee pain getting worse. Can’t weight bear. No
> additional history.
>
> Sent a text to referring looking for additional clinical information. He
> was on vacation and he had his assisstant call me. He said does it make a
> difference if this patient has “very poorly controlled rheumatoid
> arthritis?’
> Uh yes, it makes a difference.
>
> Most can be explained by poorly controlled RA. Can’t explain the
> incompletely visualized femoral medullary lesion. Intraosseous Rheumatoid
> nodule? I thought it looked chondroid at first and when I saw the T1s I
> thought poor guy, cancer. I looked up intraosseous RA nodules. Literature
> says they should be cystic.
> Makes more sense that the whole thing is RA rather than any form of
> malignancy superimposed.
>
> What do you think?
>
> Here are a bunch of images.
>
> [image: Screenshot 2022-01-19 152551.jpg][image: Screenshot 2022-01-19
> 152647.jpg][image: Screenshot 2022-01-19 152656.jpg]
> [image: de id 2.jpg][image: de id 3.jpg][image: deid 1.jpg]
> [image: Screenshot 2022-01-19 152720.jpg][image: Screenshot 2022-01-19
> 152731.jpg][image: Screenshot 2022-01-19 152742.jpg]
> [image: Screenshot 2022-01-19 152708.jpg]
> [image: Screenshot 2022-01-19 152806.jpg][image: Screenshot 2022-01-19
> 152817.jpg][image: Screenshot 2022-01-19 152831.jpg]
> [image: Screenshot 2022-01-19 152633.jpg]
>
>
>
>
